Expression of LAG-3 and efficacy of combination treatment with anti-LAG-3 and anti-PD-1 monoclonal antibodies in glioblastoma

Int J Cancer. 2018 Dec 15;143(12):3201-3208. doi: 10.1002/ijc.31661. Epub 2018 Sep 24.

Abstract

Like in many tumor types, immunotherapy is currently under investigation to assess its potential efficacy in glioblastoma patients. Trials are under way to assess the efficacy of new immune checkpoint inhibitors including anti-PD-1 or CTLA4. We here investigate the expression and efficacy of a novel immune-checkpoint inhibitor, called LAG-3. We show that LAG-3 is expressed in human glioblastoma samples and in a mouse glioblastoma model we show that knock out or LAG-3 inhibition with a blocking antibody is efficacious against glioblastoma and can be used in combination with other immune checkpoint inhibitors toward complete eradication of the model glioblastoma tumors. From a mechanistic standpoint we show that LAG-3 expression is an early marker of T cell exhaustion and therefore early treatment with LAG-3 blocking antibody is more efficacious than later treatment. These data provide insight and support the design of trials that incorporate LAG-3 in the treatment of glioblastoma.

Keywords: IFN-γ; T cell exhaustion; anti-LAG-3; anti-PD-1; glioblastoma.

MeSH terms

  • Aged
  • Animals
  • Antibodies, Blocking / immunology
  • Antibodies, Blocking / therapeutic use*
  • Antibodies, Monoclonal / immunology
  • Antibodies, Monoclonal / therapeutic use*
  • Antigens, CD / genetics
  • Antigens, CD / immunology*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Brain Neoplasms / immunology
  • Brain Neoplasms / therapy*
  • Cell Line, Tumor
  • Female
  • Flow Cytometry
  • Glioblastoma / immunology
  • Glioblastoma / therapy*
  • Humans
  • Immunohistochemistry
  • Immunologic Memory
  • Lymphocyte Activation Gene 3 Protein
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Middle Aged
  • Programmed Cell Death 1 Receptor / immunology*
  • Survival Analysis
  • Xenograft Model Antitumor Assays

Substances

  • Antibodies, Blocking
  • Antibodies, Monoclonal
  • Antigens, CD
  • Antineoplastic Agents, Immunological
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Lymphocyte Activation Gene 3 Protein